The study took as its point of departure the Children’s Act No 38 of 2005 that emanated from the Bill of Rights enshrined in the Constitution of the Republic of South Africa (Act 108 of 1996). This Act has as its primary aims, to promote the preservation and strengthening of families and to give effect to the rights of children as enshrined in the Constitution of the Republic of South Africa, including: protection of children from maltreatment, neglect, abuse or degradation and the fact that the best interest of a child are of paramount importance in every matter concerning children. It was anticipated that the areas of the Children’s Act with its emphasis on the rights of children would empower them in relation to their protection and development in that particular context. When the Act was introduced, it evoked mixed reactions with certain segments of society applauding the government for its efforts, and others condemning the government’s approach towards reproductive health issues affecting children. The primary aim of the research project was to explore the views of a group of parents in the Johannesburg Metro Region 11 regarding reproductive health care as embedded in the Children’s Act. The study took the form of a small-scale, mixed methods, descriptive, cross-sectional survey research design as it sought to elicit participants’ views on those specific clauses in the Act. In addressing the aims and objectives of the study, interview schedules were administered to 35 participants on an individual, face-to-face basis. Participants were adults drawn from Johannesburg Metro Region 11 and the data collected was analysed using descriptive statistics and thematic content analysis. The main findings that emerged from the study were that, participants did not participate in the process leading up to the promulgation of the Children’s Act No 38 of 2005. Consequently, participants had little knowledge about the Act and did not have any knowledge about its objectives. The fact that participants did not support certain clauses has implications for amendment of the Act with reference to the clauses on reproductive health care.

Little is known about the factors that influence people from the Caribbean to seek reproductive health services in the United States. In this paper, I focus on Indo-Caribbean women from Guyana and Trinidad who undertake reproductive journeys to New York. I ask: (1) What influences Indo-Caribbean women to begin their reproductive journeys to Richmond Hill, New York? (2) How do Indo-Caribbean women challenge gender norms during their reproductive journeys? (3) How does women’s class inform their decision making in challenging gendered norms? After conducting 30 in-depth interviews with Indo-Caribbean women from Guyana and Trinidad who seek reproductive health services in New York, I find that Indo-Caribbean women’s reproductive journeys are influenced by sexism experienced within households, communities, and doctors’ offices, lack of proper care, legal restrictions, and unaffordable treatment. Another driver is support from women networks. Social networks helped women challenge gendered norms around motherhood that are present within communities in home countries. As women receive support from their networks, they challenge gender norms varied by their class. Women from middle-income households are more likely to challenge gender norms outwardly. Obtaining reproductive health care abroad becomes a journey with multidimensional experiences of gendered negotiations and constraints.

<p>This dissertation, broadly, examines how power dynamics manifest during clinical interactions related to vague and gendered medical symptoms, such as pelvic pain. To examine this issue, I approach my research questions through multiple methods including a critical discourse analysis of the medical discourse on pelvic pain, a survey experiment administered to healthcare workers in the US, and a narrative analysis of pelvic pain patient experiences. While the focus of this research is on pelvic pain, the analyses presented here reach far beyond ideas of power dynamics and pelvic pain. Rather, the findings from this research speak to theoretical discussions medical sociologists have been having for decades. Specifically, findings provide new insight on: 1) the limits of evidence-based medicine as a biomedical paradigm, 2) how fundamental causes of health inequality intersect with each other as well as other factors, such as gender, important in predicting health outcomes and 3) how discussions of metamechanisms in fundamental cause theory can inform our understanding of the accumulation of cultural health capital. In providing such insight, this dissertation uses the case of pelvic pain to integrate multiple perspectives and theories in medical sociology to drive the field forward in a way that acknowledges the many ways power is simultaneously constituted in the clinical interaction. From the role of gender, race, and class in power relations, to the ways medical knowledge, discourse, and authority dictate the clinical interaction, this research covers a wide range of sociological theories and concepts. In doing so, this dissertation sheds new light on current understandings of power in the clinical interaction and its relationship to inequitable health outcomes in the US.</p>

The study was done to assess the information and care the men and women have on PCC and develop strategies that could improve provision of PCC that could advance maternal and newborn outcome after pregnancy in Malawi. Most for the interventions to improve pregnancy outcome are done too late in Malawi but there is an opportunity during preconception period to plan to improve the health of the couple so that the goal of a healthy mother and baby is attained. The objectives were to: explore and describe the knowledge men and women of childbearing age have on HTSP and PCC, identify variables that influence men and women to acquire appropriate knowledge on PCC and finally to develop strategies that could assist provision of PCC in developing countries like Malawi. Adverse issues that affect the couples could be addressed promptly before the occurrence of pregnancy. A quantitative non-experimental descriptive-correlation design method was used to determine the knowledge men and women of childbearing have on HTSP and PCC. A structured questionnaire was used to collect data from 300 men and women of childbearing age. The target population for the study was prospective parents that are couples that have an intention to conceive, women of childbearing age that could be accessible at family planning, gyneacological and under-five clinics between the ages of 18-35 years. A questionnaire was adapted from a study conducted in Texas. SPSS version 20 was used to analyse the data by generating frequencies and chi- square. Kruskal Wallis test was used to determine relationship between variables and knowledge on preconception care. The constructs examined were psychological preparation, reproductive health care and the physical care that are provided to ensure a healthy pregnancy outcome. With a 100% response rate the findings indicated a gap of information and care on PCC.Services on PCC were not available in the clinics which indicated a great need to empower health care providers on PCC that could reduce maternal and neonatal mortality rate. The findings were used to develop relevant preconception strategies that would assist health providers to give PCC that would improve maternal and newborn outcomes in Malawi. / D. Litt. et Phil. (Health Studies)